Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 10184 | TX |
NPI | 1023158292 |
---|---|
Provider Name | Dr. Michael O Woehst |
First Address | Kingwood, TX 77339 |
Second Address | Kingwood, TX 77339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |